I had been on the ward long enough to feel “safe” and “comfortable” with the place. Suddenly a patient began pounding on something in his room making a loud BAM! BAM! BAM! I could feel the floor beneath my feet vibrate with each blow.
The patient began yelling- I WANT TO GO HOME! I’VE BEEN HERE TOO LONG! I WANT TO SEE MY MOTHER! I WANT TO GO HOME!
A a psych-tech went to his door and shouted into the room- STOP THAT JOHN! OR WE’LL HAVE TO GIVE YOU “THE SHOT!” AND PUT YOU IN ISOLATION…YOU DON’T WANT THAT DO YOU?!
It was an effective threat. John calmed down, started crying, and the tech left.
I asked another tech, a graduate student, one I felt some camaraderie with, about John. All he could say was, John had been there for months and rarely left his room. I asked if it was safe to go in and talk to John. The tech said- Yes, and wrote in his day notes as I went to John’s room.
I went there because:
1.) John was crying and no one seemed to care
2.) I knew from experience that compassionate human contact helps
3.) so he wouldn’t get the shot
4.) helping others helps me
5.) I’m something of a student when it comes to mental illness,
6.) it was what I was trained to do
7.) it was a rare opportunity
8.) I felt invulnerable
9.) I was a little bored
10.) people may not be what they appear to be
11.) acting like the staff made me feel safer
12.) it was the right thing to do
I stood in John’s doorframe, hesitantly. I asked if I could come in and talk. He stopped crying, seemed pleased someone had come to talk to him, and said yes.
John was a thin, pale, white boy who was barely twenty. I don’t remember what I said to him. I recall that he told me that he was a born-again Christian who had taken LSD constantly for months. Now, he slipped between hallucinations of an Old Testament fire and brimstone hell, a glorious heaven filled with angels and unbearable beauty, and being on the psych ward.
There was a pause in the conversation. I sat in silence as I considered what he told me. My oldest son was twenty. He had done a lot of hallucinogens but suffered no apparent damage. I rarely left my house. I had experienced something like the unbearable beauty John described.
John suddenly looked worried and scared. He asked–Did that hurt you? Confused, because we had only sitting in his room talking and sharing silence, I asked- Did what hurt me?
Looking down at the ground, apparently suddenly ashamed, he said- My thoughts, did you hear them? Did they hurt you? I told him–No, man, they didn’t hurt me. I can’t hear your thoughts. Thoughts can’t hurt people.
I felt a twinge of discomfort with this assertion since I had voluntarily committed myself for having violent thoughts and urges. I considered the fact that I had not acted on these thoughts and feelings and they had disappeared given the stress of the commitment process and being on a locked psychiatric ward.
John looked relieved by my verbal response, but still ashamed. I didn’t ask him what terrible thing he had been thinking that might hurt me.
From that point on, my main intent was to keep John calm and give him feedback about what was real because he reported he was slipping between heaven, hell and the ward, and all three places were unbearable.
I spent some part of nearly every day of my last week on the ward with John. He often wanted me to read his Bible to him. Reading to him was surreal for me- I neither liked, nor believed in, the Bible.
In addition, John preferred The Old Testament. I felt that it would be best not to read passages about an angry, vengeful god. I hadn’t read the Bible for years, and, unfamiliar with it after so much time, it took awhile for me to find passages about compassion and love in the Old Testament.
John waited patiently and quietly. I ended up starting one section, deleting whole paragraphs that dealt with an angry, jealous, or a vengeful God. If I got stuck in an angry, hateful section, I clumsily made up a positive ending.
John didn’t seem to notice my editing and appeared comforted by the text and my alteration of it. He indicated this by nodding his head, smiling, and paying rapt attention.
As I spent time with John, he switched from moments of normalcy to delusions regarding his thoughts. He sometimes stated others were reading and stealing his thoughts. But, his primary worry was that his bad thoughts could kill, maim and injure others. So, he had to be careful. He was often concerned about my safety when I was with him. It was touching in a bizarre way.
John believed his bad thoughts were sins- the reasons he was being sent to hell again and again, and he apparently had some very bad thoughts about his mother, which were why he could never be redeemed.
I wasn’t sure if these thoughts were sexual or violent. The few times I gently probed, he withdrew. So, I left him his privacy. I suspected he had both types of thoughts, by the way he talked about, and seemed attached to, his mother.
I reported much of this to the psych-tech I liked, and he sometimes wrote comments in his day notes. This made me feel like I was a de facto psych-tech. This gave me a sense of purpose and a sense of identity other than being just another patient.
I encouraged John to leave his room and join the other patients. To the surprise of staff, he did so. He appeared nervous at first, staying close to me. But, to his pleasure, a couple of the patients who had been there a long time came up and spoke to him. They seemed pleased and surprised to see him too.
My last few days in the psych ward they had given up trying to treat my mania and paranoia. Instead, they gave me a hefty dose of the tranquilizer Ativan.
Through the blanket feeling of well-being provided by the Ativan I felt anger, sadness and relief. I felt anger that staff could have spent just a little time conversing with John everyday and improved the quality of his life. I felt sadness that I would not interact with John anymore, and that he might never get out. I felt relief that I was free from dealing with him because some part of me found it stressful and scary- the part that didn’t ask for details about the terrible thoughts he had about hurting me.
As I left the ward to go home, John went into his room and cried.